0 278

Cited 6 times in

Safety evaluation of freehand lateral mass screw fixation in the subaxial cervical spine: evaluation of 1256 screws

 Kim, Hak-Sun  ;  Suk, Kyung-Soo  ;  Moon, Seong-Hwan  ;  Lee, Hwan-Mo  ;  Kang, Kyung Chung  ;  Lee, Sang-Hun  ;  Kim, Jin-Soo 
 Spine, Vol.40(1) : 2-5, 2015 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Screws/adverse effects* ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/surgery* ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Prospective Studies ; Spinal Diseases/diagnostic imaging ; Spinal Diseases/surgery* ; Spinal Fusion/adverse effects* ; Spinal Fusion/methods ; Tomography, X-Ray Computed ; Young Adult
cervical spine ; complications ; facet injury ; freehand ; lateral mass screw ; nerve root injury ; posterior surgery ; safety ; vertebral artery injury
STUDY DESIGN: Prospective study. OBJECTIVE: To evaluate the safety of the lateral mass screw (LMS) fixation. SUMMARY OF BACKGROUND DATA: LMS fixation has been known to have risk of injury to vertebral artery, nerve root, or facet joints. METHODS: A consecutive series of 178 patients undergoing planned LMS fixation were studied. Screw fixation was performed using the freehand technique. Entry point of screws was 2-mm medial from the center of the lateral mass. Planned divergent angle of the screw was 30º. Bicortical fixation was tried in all cases. After the surgery, all patients underwent 3-dimensional computed tomographic scan of the cervical spine. We checked the number of screws in each level, divergent angle of the screws, and violation of foramen transversarium (FT), intervertebral foramen, or facet joint by screws. A reliability test was performed. RESULTS: Total 1256 screws were fixed with 269 at C3, 318 at C4, 331 at C5, and 338 screws at C6. Mean divergent angle of the screws were 34.7º/33.1º at C3, 33.9 º/32.1º at C4, 34.7º/32.7º at C5, and 33.6º/30.7º at C6. Incidence of FT violation was 0.876%. FT violation was most common at C6 (6/11 violations). Mean divergent angle in cases of FT violation was 15.0º and was significantly smaller than that of safe cases. There was no injury to vertebral artery. There was no violation of intervertebral foramen. Incidence of facet violation was 1.433%. Seventeen facet violations were within fusion segment. Only 1 screw violated healthy facet. Facet violation was most common at C3 (12/18 violations). CONCLUSION: LMS fixation is a safe stabilizing technique with very low incidence of violation of FT, intervertebral foramen, and facet. There is a possibility of FT violation if the divergent angle was small. FT violation was most common at C6. Facet violation was most common at C3.
Full Text
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hak Sun(김학선) ORCID logo https://orcid.org/0000-0002-8330-4688
Moon, Seong Hwan(문성환)
Suk, Kyung Soo(석경수) ORCID logo https://orcid.org/0000-0003-0633-2658
Lee, Hwan Mo(이환모) ORCID logo https://orcid.org/0000-0002-5405-3832
사서에게 알리기


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.